Factors associated with increased serum levels of specific markers of myocardial injury--cardiac troponins T and I in chronic haemodialysis patients.

Serum concentrations of the cardiac troponins (cTn) T and I, specific markers of myocardial injury, are frequently elevated in haemodialysis patients. The clinical relevance of this is unclear. The purpose of this research was to investigate possible factors associated with increased serum levels of cardiac troponins (cTn) T and I, specific markers of myocardial injury, in chronic haemodialysis patients. Cross-sectional research was conducted and 150 chronic haemodialysis patients without acute coronary symptoms were investigated (mean age of patients 60+/-15 years). Clinical and echocardiographic data, biochemical status, and haemodialysis regimen were evaluated for each patient. Pre-dialysis serum cTnT, cTnI, and CK-MB concentrations were determined. Logistic regression was the principal method of analysis. Pre-dialysis levels of cTnT >0.1 ng/ml (n=28, 19.6% of patients) were associated with age (P<0.001), diabetes (P<0.005), history of ischemic heart disease (P<0.05), and left ventricular hypertrophy (P<0.05). In multivariate analysis, age odds ratio (OR 1.04), diabetes (OR 4.9), and indexed left ventricular mass (OR 1.01) were found to be independently associated with cTnT concentration above the threshold. Elevated baseline serum levels of cardiac troponins were associated with cardiovascular risk factors, history of ischemic heart disease and left ventricular hypertrophy in asymptomatic chronic haemodialysis patients.